Exam4- HIV disease

Question 1

HIV patho

Answer 1

retrovirus

-changes itself to be inserted into the host and it can never be killed

Question 2

What is HIV’s genetic material?

Answer 2

RNA: single stranded ribonucleic acid

Question 3

How is RNA converted in the HIV life cycle?

Answer 3

Reverse transcriptase (RT) is used to covert single stranded RNA into double stranded DNA

Question 4

Role of intergrade enzyme in the HIV life cycle

Answer 4

Integrase enzyme allows the viral double stranded DNA to be inserted into the double stranded DNA of the host

Question 5

HIV Life Cycle

Answer 5

1. Attachment and fusion
2. Injection of core
3. Uncoating
4. Conversion to DNA
5. Circular DNA
6. Entrance into nucleus
7. Integration
8. Transcription
9. Translation
10. Protein modification
11. Assembly of core
12. Budding

Question 6

Effects of HIV

Answer 6

0f CD4+ T-cells patient has, whether any opportunistic infections have occurred, indicates difference

Immune system can attack & destroy early on; 3 of HIV particles overwhelms system over time

Question 7

HIV s/s

Answer 7

• acute infection develops within 1st month after infection
• night sweats, chills, headaches, muscle aches, rash,, sore throat

-symptoms fade & patient feels better (some may not look into the symptoms due to them leaving so fast)

Question 8

Stage 1

Answer 8

confirmed HIV infection

CD4-T call count >500 cells mm3

Question 9

Stage 2

Answer 9

Confirmed HIV infection

CD4 T-cell count b/w 200-499 cells mm3

Question 10

Stage 3

Answer 10

confirmed HIV infection

CD4 T-cell count <200 cells mm3 or > 200 with a documented AIDS defining illness (ex. pneumocystis pneumonia)

Question 11

Stage 4

Answer 11

Confirmed HIV infection
No other information regarding CD4 cell counts or AIDS defining illness
Not worse, just don’t know the answer to the questions

Question 12

Long-term nonpregressors (LTNPs)

Answer 12

genetic mutation does cause a resistance to the virus entering the host cells. HIV positive for greater than 10 years & without symptoms

Question 13

Health Promotion

Answer 13

Educate best hope for prevention

Question 14

3 ways HIV usually transmitted

Answer 14

sexual
parenteral
perinatal

Question 15

ABCs

Answer 15

A- abstinence
B-be faithful to one partner
C- use condoms

Question 16

Transmission Health care workers

Answer 16

needle stick injuries
exposure to non intact skin/mucous membranes to blood and body fluids

STANDARD PRECAUTIONS ARE BEST PREVENTION!!!

Question 17

Management

Answer 17

Assessment - ask questions
Hx
Physical Assessment/clinical manifestations: Infections, Malignancies, Endocrine complications

Question 18

Manifestations: Infections

Answer 18

opportunistic, protozoal, fungal, bacterial, viral

Question 19

Manifestations: Malignancies

Answer 19

Kaposi’s scarcoma, malignant lymphomas

Question 20

Manifestations: Endocrine complications

Answer 20

Gonadal dysfunction
Body shape changes
Adrenal insufficiency

Question 21

Manifestations: AIDS dementia complex

Answer 21

occurs in 70% of those with AIDS

Varies in severity

Question 22

Manifestations: AIDS wasting syndrome

Answer 22

altered metabolism

GI dysfunction

Question 23

Manifestations: Skin changes

Answer 23

dry, itchy irritated skin

Question 24

viral load

Answer 24

amount of virus present in blood/other body fluids

should be less than 50 if they are taken regularly
more likely t transmit with high viral load

Question 25

Higher Blood levels of HIV (viremia)

Answer 25

greater risk for sexual/perinatal transmission

Question 26

Lymphocyte count

Answer 26

WBC <3500 cells/mm3

Question 27

CD4+ T-cells & CD8+ T-cells

Answer 27

ratio normally is 2:1 normal CD4 is 500-1500 AIDS can be fewer than 100

Question 28

Antibody tests

Answer 28

ELISA: early testing can result in false negative | Western blot, viral load: more accurate, more expensive, used to confirm presence of HIV

Question 29

Quantitative RNE assays

Answer 29

used to monitor therapy

Question 30

Home test kits

Answer 30

dont want family to know may be more difficult to get insurance with HIV Needs confirmation by blood test

Question 31

HAART: Highly Active Antiretroviral Therapy

Answer 31

``` NRTIs: Zidovudine NNRTIs: Delavirdine Pis: Atazanavir Fusion inhibitors: enfuvirtide Entry inhibitors: Maraviroc Integrase inhibitors: Raltegrase ``` cART= combination antiretroviral therapy (new name)

Question 32

Safe Sex Practices

Answer 32

Latex or polyurethane condoms Latex gloves Dental Dams New research- vaginal gel with antiretroviral agent

Question 33

Priority patient problems

Answer 33

``` potential for infection inadequate oxygenation pain inadequate nutrition diarrhea reduced skin integrity confession reduced self-esteem potential loss of social contact ```